Evidence map›Paper›PMID 37168819›Full record

ArticleContemporary clinical trials communications2023

Stepped care versus center-based cardiopulmonary rehabilitation for older frail adults living in rural MA: Design of a feasibility randomized controlled trial.

Liana Fraenkel, Quinn Pack, Leslie Drager, Jagruti Patel, Paulette Pontier, Peter K Lindenauer

Open access · goldAbstract read
In one paragraph

Article in Contemporary clinical trials communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 46% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. The importance, consequences and treatment of psychosocial risk factors in heart disease: less conversation, more action!Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Liana FraenkelBerkshire Medical Center, Berkshire Health Systems, Pittsfield, MA, USA.
Quinn PackDepartment of Healthcare Delivery & Population Sciences, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, USA.
Leslie DragerBerkshire Medical Center, Berkshire Health Systems, Pittsfield, MA, USA.
Jagruti PatelBerkshire Medical Center, Berkshire Health Systems, Pittsfield, MA, USA.
Paulette PontierFairview Hospital, Berkshire Health Systems, Great Barrington, MA, USA.
Peter K LindenauerDepartment of Healthcare Delivery & Population Sciences, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, USA.
Berkshire Medical Center · USUniversity of Massachusetts Chan Medical School · USBerkshire Health Systems · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Stepped care versus center-based cardiopulmonary rehabilitation for older frail adults living in rural MAR34HL156920 · NHLBI · BAYSTATE MEDICAL CENTER, INC. · PI FRAENKEL, LIANA, LINDENAUER, PETER KYLE · 2022 to 2024
$544k
NCATS NIH HHS UL1 TR001863NHLBI NIH HHS R34 HL156920
6 · The paper itself

Abstract

Background: Cardiac and pulmonary rehabilitation programs are grossly underutilized, and participation is particularly low in rural regions. Methods: We are conducting a 2-arm, randomized controlled feasibility trial. Eligible participants include older frail adults with cardiac or pulmonary disease living in a predominantly rural county in western Massachusetts. Participants are randomized 1:1 to treatment as usual or stepped care. Patients randomized to treatment as usual participate in twice weekly center-based rehabilitation sessions over eight weeks and are encouraged to exercise at home in between sessions. Patients randomized to the stepped-care arm are offered/enrolled in the center-based rehabilitation program followed by possible step up to three interventions based on prespecified non-response criteria: 1) Transportation-assisted center-based rehabilitation, 2) Home-based telerehabilitation, and 3) Community health worker-supported home-based telerehabilitation. The primary feasibility outcomes are average number of eligible patients randomized per month, baseline measure completion, proportion attending at least 70% of the prescribed sessions, average number of sessions attended in the stepped-care arm, and proportion in the stepped-care arm completing patient reported outcome measures. Each of these process indicators is evaluated by preset "Stop" and "Go" thresholds. Conclusion: The proposed stepped-care model is an efficient, patient-centered, approach to expanding access to cardiac and pulmonary rehabilitation. Meeting the "Go" thresholds for the prespecified process indicators will justify conducting a definitive full-scale randomized controlled trial to compare the effectiveness and value (cost-effectiveness) of stepped-care versus center-based rehabilitation in older frail adults living rural counties.

Identifiers

PMID37168819
PMCPMC10164764
OpenAlexW4366753700

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.